Department of Psychiatry, Sir Run-Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.
BMC Psychiatry. 2023 Jun 27;23(1):470. doi: 10.1186/s12888-023-04952-0.
Low-grade inflammation and altered inflammatory markers have been observed in treatment-resistant schizophrenia (TRS). Interleukin-6 (IL-6) is one of the pro-inflammatory cytokines linked with TRS and receives increasing attention. Previous studies showed that patients with TRS might have higher IL-6 levels compared with healthy individuals and treatment-responsive patients. Besides, emerging evidence has suggested that there are sex differences in the associations between IL-6 levels and various illnesses, including chronic hepatitis C, metabolic syndrome, etc.; however, there is limited study on TRS. In this present study, we aimed to compare the serum IL-6 levels of TRS and partially responsive schizophrenia (PRS) and explore potential sex differences in the association of TRS and IL-6 levels.
The study population consisted of a total of 90 patients with schizophrenia: 64 TRS patients (45.3% males and 54.7% females) and 26 PRS patients (46.2% males and 53.8% females). We measured serum IL-6 levels using enzyme-linked immunosorbent assay (ELISA) and analyzed them separately by gender, controlling for confounders (age, education, medication, body mass index, and PANSS scores) rigorously.
The results showed that patients with TRS had higher serum IL-6 levels than patients with PRS (p = 0.002). In females, IL-6 levels increased significantly in the TRS group compared with the PRS group (p = 0.005). And a positive correlation tendency was observed between IL-6 levels and PANSS general sub-scores (r = 0.31, p = 0.039), although this correlation was not significant after correcting for multiple comparisons. Whereas, there were no differences in IL-6 levels between the TRS and PRS (p = 0.124) in males.
Our findings provided evidence supporting the hypothesis that the inflammatory response system (IRS) may play a role in the pathogenesis of TRS in a sex-dependent manner. In addition, sex differences in the immune dysfunction of individuals with schizophrenia cannot be neglected, and inflammation in male and female TRS should be discussed separately.
在治疗抵抗性精神分裂症（TRS）中观察到低度炎症和炎症标志物改变。白细胞介素 6（IL-6）是与 TRS 相关的促炎细胞因子之一，受到越来越多的关注。先前的研究表明，与健康个体和治疗反应性患者相比，TRS 患者的 IL-6 水平可能更高。此外，新出现的证据表明，IL-6 水平与包括慢性丙型肝炎、代谢综合征等在内的各种疾病之间的关联存在性别差异；然而，TRS 的研究有限。在本研究中，我们旨在比较 TRS 和部分反应性精神分裂症（PRS）患者的血清 IL-6 水平，并探讨 TRS 和 IL-6 水平之间关联的潜在性别差异。
研究人群包括 90 名精神分裂症患者：64 名 TRS 患者（45.3%男性和 54.7%女性）和 26 名 PRS 患者（46.2%男性和 53.8%女性）。我们使用酶联免疫吸附测定（ELISA）测量血清 IL-6 水平，并分别按性别进行分析，严格控制混杂因素（年龄、教育、药物、体重指数和 PANSS 评分）。
结果显示，TRS 患者的血清 IL-6 水平高于 PRS 患者（p=0.002）。在女性中，TRS 组的 IL-6 水平明显高于 PRS 组（p=0.005）。尽管在进行多重比较校正后，这种相关性没有统计学意义，但仍观察到 IL-6 水平与 PANSS 一般分量表之间存在正相关趋势（r=0.31，p=0.039）。然而，在男性中，TRS 和 PRS 之间的 IL-6 水平没有差异（p=0.124）。
我们的研究结果为 IRS 可能以性别依赖的方式在 TRS 发病机制中起作用的假设提供了证据。此外，不能忽视精神分裂症个体免疫功能障碍的性别差异，应分别讨论男性和女性 TRS 的炎症。
